A Diagnostic Hearing Test Vs the “Free Hearing Test” – The Essential Difference

May 12, 2019

At Harmony Hearing we offer a free hearing screening check as well as a more comprehensive diagnostic hearing test. 

The Free Screening Hearing Test (A Basic Check)

We schedule an approximate 30minute appointment where we look into your ears and perform a basic four frequency check of your hearing. We check the frequency range important for speech understanding. Although this check identifies if there is significant hearing loss, it doesn’t show its impact on communication ability or what underlying health conditions are contributing to hearing loss, tinnitus or balance issues. 

 A diagnostic test shows the nature of the hearing loss, helps indicate underlying causes and identifies a suitable treatment plan.

The Diagnostic Hearing Test (Comprehensive)

Your appointment will last 1 to 1.5 hours with our experienced Audiologists. This duration gives us enough time to conduct a comprehensive hearing assessment, discuss the results and a potential treatment plan. If hearing aids form part of the recommendations, then we can perform an in-clinic demonstration of different models and styles that may be suitable.

Finding out about you, your hearing and your heath:

Hearing & Communication Goal Setting 

We like to have a conversation to find out about your hearing concerns and lifestyle communication needs. By writing down some hearing and communication goals we can start developing a rehabilitation program as required. 

General Medical Health History 

We ask a number of medical style questions to help identify any underlying health concerns that could be related to your ear health or hearing. This includes questions such as your history of noise exposure or medicines that could affect your hearing. 

Outer Ear Testing & Examination – Otoscopy

We will examine the outside of your ear first, then we look inside your ear with an instrument called an Otoscope. We check your ear canal and ear drum health. If there is wax or debris blocking the ear canals and obscuring the view of the ear drums most clinics will defer the test and expect their client to see their GP to have it removed before returning for another appointment to complete the test. At our clinics our Audiologists are trained in gentle wax removal and will remove the wax/debris as part of the test appointment saving you a trip to your doctor and a repeat visit to the hearing clinic.

Middle Ear Testing – Tympanometry

This test indicates both middle ear pressure and mobility. Your middle ear includes your ear drum, the middle ear bones, and your Eustachian tube. It shows how efficiently the ear drum and middle ear bones are conveying the mechanical sound vibration through to the inner ear. This can tell us if the ear drum and middle ear bones are working well and moving normally or not. It can indicate whether there are middle ear issues such as fluid or congestion behind the ear drums. It can reveal abnormalities which indicate and explain a conductive hearing loss and/or a sensation of pressure in the ear.

How Tympanometry is performed

An ear tip is placed in the ear canal and connected to a handheld machine. It varies the pressure in the ear canal from a slightly positive to negative pressure whilst emitting a low frequency tone. It has a sensitive microphone that measures how efficiently the tone is transmitted through the middle ear (known as compliance) vs how much of the low tone is reflected. By varying the pressure the movement of the ear drum can be measured. You will not need to respond during this test.

Entire Ear Testing – Pure Tone Audiometry

Headphones or insert ear phones are placed on you and measure the faintest sounds you can hear. The test is best performed in a sound proof booth or at the very least a quiet room. You press a button every time you hear a sound or tone. The tones start off louder and decrease gradually until they are very faint. We aim to measure the very faintest sounds you can hear across the frequency or pitch range. This will tell us whether your hearing is within normal range or if there is hearing loss and botthe type and level of hearing loss. This is performed across the frequency range most valuable for speech understanding. 

hearing test

We then use a Bone Conductor which sends the sound vibration straight to the inner (the cochlea). This test enables us to determine what part of the ear is affected and causing hearing loss. 

The results are plotted on a graph called and Audiogram which shows the normal hearing range and the varying levels of hearing for each pitch of sound.

The Audiogram

The Audiogram shows your hearing sensitivity or thresholds for both ears across the frequency range. It answers the question of whether or not your hearing sensitivity is within the normal range. It also shows the degree to which any hearing loss is outside the normal range. The test will also show any difference in hearing sensitivity between the ears known as asymmetry. 

The Audiogram

The configuration of the Audiogram (shape of the thresholds) and the rest of the group of tests gives us information toward the diagnosis of ear abnormalities.  

Speech Testing (Ear & Brain Testing)

Most people experience difficulty following speech in competing background noise, however this is not routinely tested. We include functional speech in noise tests which simulate real world listening environments. It gives vital information as to your ability to hear and process speech information in quiet and in varying levels of competing noise. 

The test gives us further information on the status of your inner ear and auditory processing ability. It can help diagnose nerve damage/deterioration and is a good indicator of possible benefit from hearing aids. Data recorded from this test enables us to assess the impact that your hearing loss is having on your speech understanding in both quiet and noisy environments. As part of the test battery the functional speech test helps diagnose ear and hearing abnormalities. It is also an excellent tool for assisting us in recommending suitable hearing aids because it allows us to define the sounds in speech you have the most difficulty with. 

How it is performed

Words or sentences are presented at average conversation levels approximately 50dB HL. You are asked to repeat back the words in list or at the end of a sentence. Competing noise is incrementally increased to make the test progressively more challenging. Your responses are recorded and discussed.

Explanation of the Results and Recommendations

After the assessment battery is complete we give you a clear and thorough explanation of the results. We use demonstrations and displays on a mounted TV screen.  If required we then discuss possible solutions to help you return to a more normal level of hearing and allow you to engage more fully in your life.

Hearing Aid Benefit Assessment & Demonstration 

If you are a suitable candidate for hearing aids, we will move into discussing the various styles and models available and suitable for your defined hearing loss. We can demonstrate different models and styles in the clinic programming and configuring them to your hearing levels. You can experience how they can sound and feel and it will allow you to begin to understand the benefits they provide.

Go to the Hearing Test Accompanied

We encourage you to bring your partner or significant other to any of your appointments with us. It’s all about communication and making it easier for you and your significant others. A second person to help remember important information. As you re familiar with their voice they can assist in a sentence test that can help you assess hearing aid benefit. 

Aided Vs Un Aided Test

Following the fitting of a hearing instrument we will run the speech discrimination tests again to compare how you are able to perform. By comparing the results between the Un-Aided and Aided speech discrimination test performed under the same conditions we attain a good indication of the aided benefit in terms of improved speech discrimination. 

Why is a Diagnostic Hearing Test So Important?

The quality and comprehensiveness of the hearing test is important and can vary significantly from the “free hearing test”. It is important to see the distinction. The Diagnostic Assessment consists of a group or set of complimenting tests (a test battery) that gains enough information or data to form a more in depth analysis of your ear health, your hearing health and communication ability. It is dangerous to misconstrue the free hearing test which may consist merely be a single test to check of hearing sensitivity across several frequencies. Such a basic check forms an incomplete picture and can easily miss important underlying ear health and general health issues that can and should also be addressed with medical intervention. 

If medical concerns are detected in our comprehensive test and Audiological report is send to your doctor to aid further investigation and intervention. 

Most of the large hearing chain companies intensively advertise the offering of a “free hearting test” to get you in. They have a focus on selling hearing aids to remain highly profitable and make up for their free services with high prices and margins on their hearing aids. After all what trained professional with many years of experience gives away all their time and time for free? 

At Harmony Hearing we pride ourselves on having more of a health focus. We understand that a diagnostic hearing test forms the foundation of a building a genuine hearing health care solution.  For self-funding clients’ we charge $120 for the 90 minute assessment. Eligible pensioners and veterans can have this service paid for through the Australian Governments Hearing Service Program. There may be private health fund rebates that apply. 

With our expertise and care you can be assured of an effective long term hearing & communication solution. 

Call Harmony Hearing and book your comprehensive diagnostic hearing test now.

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